Josh Clemente of Levels Health — The Future of Health, Metabolic Fitness, and Biometrics

What’s keeping humanity stuck on Earth? For Josh Clemente, the answer may be – at least partially – our poor health. After experiencing the rough symptoms of metabolic dysfunction, Josh started Levels Health to help users access personalized data about their diet’s impact. Levels uses a continuous glucose monitoring device and user-focused software to translate real-time health data into actionable insights. In this episode of Build the Future, Josh and Cameron talk about how personalized nutrition is poised to take humanity further than ever. The topics covered include the four levers of metabolic health, our prescription-happy society, and why healthier humans are more likely to reach the stars.

• Check out Levels
• Follow Levels on LinkedIn or Twitter
• Connect with Josh Clemente on LinkedIn or Twitter
• Check out Build the Future
• Connect with Cameron Wiese on Twitter

1:24 – Data goes health-conscious

With data analytics tech at our fingertips, applying it to optimize our health is the logical next step.

“So the vision is to reverse the trends of metabolic dysfunction in the developing world by giving people access to their own health information at the moment that it matters. Every day we all sit down, we’re going to eat lunch. We’re going to make a choice. Why do we make that choice? Right? What are the reasons that we’re choosing to eat that lunch that we choose and why? A lot of the time we’re basing these things on emotion, on the advice of others on internet searches. In this world where we have a microelectronics revolution that is allowing this miniaturization of technology that otherwise would never have been able to leave the lab – we need to be leveraging this in society. And, you know, we use data throughout our lives with the exception of health and wellness. And so Levels is there to be providing easy, actionable insights to help you make better choices and ultimately allow human flourishing by giving people access to their own information at the moment that is valuable.”

2:19 – Lower glucose, save the world

In a world plagued by metabolic dysfunction, a growing health and diet awareness can prevent the leading causes of early death.

***“*So Levels is focused – or the metabolic fitness companies are focused – on the space of metabolic health. And the reason we’ve chosen this is because it is the unspoken epidemic that is causing the most destruction across the world. In every developing country, specifically the United States, metabolic dysfunction is the leading cause of death. If it’s not specifically a metabolic failure that leads to morbidity, it’s a closely associated comorbidity. And so we’re talking about things like PCOS, pre-diabetes, type two diabetes, cardiovascular disease, stroke, Alzheimer’s. All of these are metabolic in nature, very closely related to metabolic dysregulation…And so metabolic dysfunction is when these processes start to break down and we have harmful byproducts, hormones, and control of the glucose-insulin feedback loop break down. And we start to damage tissue. We start to age prematurely, free radicals inflammation, all of that starts to build. And ultimately, that is what leads to end of life. And so it’s an accelerating aging process, basically. So we’ve chosen the metabolism, because again, seven of the top 10 reasons people are losing their lives early are related to metabolic dysfunction. And it doesn’t have to be this way.”

6:15 – Empowerment through data

How can we make a difference to our health? By capturing the real-time, data-driven results of our diet and actions.

“When you sit down to eat lunch right now, it seems like you need a Ph.D. to figure out what you should put on your plate. And so when you’re operating in that world, you can’t blame people who are busy and trying to live their lives for ultimately having to just make a choice that they enjoy. So we’re doing things based on emotion. We’re guided by flavors, for example, or we’re guided by – if we are taking data – it’s the bathroom scale. So we’re like, ‘Oh man, I’ve gained a few pounds. I should stop eating.’ We can’t blame specific foods and we can’t understand how specific choices are affecting us because the feedback loop is so open and ultimately broken. And so by connecting a person with the reactions their body experiences from a specific action in real time, giving them data that associates the metabolic outcome of a certain choice – we can close that loop. We now can connect the action to the reaction, put that information in the hands of the individual and they can now understand specifically why they should choose one behavior over another. And so that’s the real power.”

9:52 – Warning: choices may be less healthy than they appear

Josh’s personal experience taught him that so-called healthy diets can still be hurting your personal metabolic response.

“I personally started this whole process that ultimately led to Levels because even though I’m a CrossFit level two trainer and I was working out daily, I was experiencing extreme fatigue levels throughout the day, like total fluctuations. I’d feel an energy boost and then 20 minutes later, an hour later I’d be crashing and I’d be like crawling back to the coffee machine. That experience was caused ultimately, I found, by the hormonal imbalance, the insulin waves that I was experiencing as a result of my dietary choices. And at the time I was not eating, you know, what would be traditionally thought of as an unhealthy diet. The staples of my diet were brown rice and sweet potatoes, but the quantities I was eating them in and my own personal sensitivity to them was causing this huge blood sugar excursion into the pre-diabetic range, which would lead to this overcompensation of insulin. And people are experiencing this daily and they’re experiencing it in response to choices they think are objectively healthy.”

11:49 – Getting to know your body

Toss out the Atkin’s diet – studies show that each individual processes sugars and food types differently, and understanding your body leads to healthier choices.

“We call it food freedom. But it’s the concept of the realization that you are an individual. You’re not an average. And what we do in modern diet theory and nutrition is we average out everyone and we turned it into an optimal diet. We say, this is the diet for everyone. Everyone should eat this way. What we’re doing is we’re erasing the individual reality. And so CGM technology, continuous glucose monitoring technology specifically, has recently uncovered this reality of metabolic personalization. So you may have heard of this trial that came out in 2015, in which 800 non-diabetic people were given continuous glucose monitors. And during the trial, they ate all these standardized meals. And, at the end, they went back and looked at the data and had this amazing realization that two people can have the exact same two foods and have equal and opposite blood sugar responses to them. So we’re talking about no response, for example, to a cookie and a huge blood sugar response to a banana and then for a different person, the exact opposite. So how can you know if you’re that banana or cookie person unless you have that data.”

15:15 – From reactive to proactive choices

Levels currently can only evaluate your past choices, but Josh sees a path towards active recommendations and diet scheduling for your lifestyle.

“All of these molecules that really do matter, they’re quarantined in the world of boutique medicine. If you get this extremely expensive lab work, you can have an idea of where you stand on all these metrics. We’re going to see a transition to very real-time, continuous monitoring, where you have a bio wearable on your body somewhere that is analyzing these analytes in real-time and delivering you low-hanging fruit, no pun intended, for better behavior. So right now we’re reactive. We’re saying, monitor and then find the problems and change them. In the future, we’ll be proactive. It’ll be, ‘Hey, you know, it’s Tuesday morning, you’ve got a training event on your calendar. Here’s the recommended fuel source before you go out and get on the biker or go for that swim’. Or you’re trying to lose weight, you could potentially do so by simply staying in a low-glycemic state and optimize cholesterol simultaneously by having real-time monitoring of both. And you don’t have to restrict calories, you just eat differently. Right? These are the things that unlock when you start to have real-time data at the individual level.”

16:44 – Dreaming bigger, Levels-style

Levels isn’t just another start-up, it’s the stepping stones towards a happier, healthier, and richer future for humankind.

“I can envision a future where we’re like striding into our nineties fitter and wiser than ever. And without that unnecessary breakdown. Now, I’m not someone who believes that we’re going to achieve immortality. Of course, I don’t know. I don’t know enough about it, but I do think that we have a ton of unnecessary aging and breakdown that is a by-product of our lifestyles. Nobody, again, wants to be in that situation. It’s just we don’t have any feedback as we’re going through life. And so I think that the beautiful consequence of having that real-time information guiding us throughout life is that we’ll have so much more richness and value at both ends of the spectrum. When we’re younger, we’ll be able to make better choices and experience better – our quality of life will be better. And as we’re older, we’ll be able to age more gracefully and be in more control. And I don’t want to make it all about productivity, but it just unlocks so much for society.”

https://s3-us-west-2.amazonaws.com/secure.notion-static.com/3d46e8a9-0898-436c-8cd4-ebbeda4dfa40/Dreaming_bigger_Levels-style_-_Build_the_Future.mp4

18:15 – Think beyond the antibiotic

We tend to treat the symptoms of metabolic dysfunction with medication – but data-driven choices can be far more effective.

“I also think that the mechanisms are so misunderstood. We think that we have to treat everything with pills and with procedures or something like that. Part of it is with our society in general, we like to have a problem that we can solve. And so if we can put pills or a procedure on it, it’s like we can check that box and then we fix the problem. But the reality is that this is a much more nuanced world. The world of human physiology and health is super coupled. Again, we’re this chemistry set. And if things are out of whack, we just like throw more chemicals at the problem and assume that’s going to correct it. And what we’re doing is we’re just covering up the symptom. And so what I think is, is really extraordinary about being able to use a data-driven approach is that we can target and improve these sort of chemical disturbances.”

20:20 – Putting you in the driver’s seat

In a world of generic diet advice, real-time personalized data gives users strong control over their choices and health impacts.

“I think that most people really do respond positively to this opportunity. They understand that they are different than other people, and they’ve maybe tried a diet that was recommended to them by a friend or something. And it didn’t feel right. So we have this sort of intraception where we think that something’s off, or we can perceive that there’s no one size fits all. But then when you actually have information from your own body, telling you how to make better choices or what is working against you? It’s very hard to ignore, it’s not something most people are used to. We don’t have closed feedback loops from our bodies. It’s an eye-opening experience once you, for the first time, hear your body speak back to you and you can make choices in a closed-loop, it’s a really empowering situation to be in. And that’s why I’m so optimistic for it – it doesn’t feel the same as the sort of age-old advice of ‘eat healthier and work out more.’ It’s seeing that when you eat healthier, your body is healthier. And when you work out more, you have better control or you can maybe even indulge a little bit more without seeing dysfunction. And so all these little micro-optimizations that you can see and really verify for yourself, it’s like putting you in the driver’s seat instead of always feeling like you’re on the backseat.”

21:54 – Use it your way

Levels – and CGM in general – can be used for any performance or health improvement goals that you have for your lifestyle.

“We all have different performance goals, you know, and it could be just being a good performer at work. It might be being a better spouse, better husband, father, mother, sibling, there’s all these different reasons that we need to be good performance and be kind of on top of our game to enjoy life. And then you’ve got the metabolic health spectrum, which is like, maybe you want to lose weight. Maybe you want to shave seconds off your 50K time or something. There’s like all of these different reasons that you would care about metabolic optimization, but when it comes down to at the very, very basic level is it’s the same few molecules that drive our energy balance. And so if we’re empowered, no matter where we land on the metabolic health spectrum or what our goals are for, to access and make choices that either improve the molecules that are at play. Ultimately we basically closed the loop between better choices over a short time period, leading us closer to our goals.”

27:04 – Your health 401(k)

As biotech capability grows, Josh envisions a  future where you can track, invest in, and project multiple factors of your health just like your retirement fund.

“I would say project forward, you have kind of a smart health stack where you’re taking data on those big four levers, sleep, stress, diet, and exercise. Those are the things that you can control at the individual level. And you are currently making choices every day on all four of those. It’s just whether or not you’re paying attention. So once you have data on all four, that’s where we sort of step into the world where metabolic health data is more like financial data. So you’ve got like a real-time portfolio of data streams. You’re making choices in a closed loop. You have the deposits and withdrawals, right. You’ve got a projection into the future. You’ve got expert guidance if you need it, that you can opt into. This is all available in the moment while you’re riding the subway or whatever, you pull your phone out, take a look at how you’re doing and adjust your expectations or adjust your choices that day to optimize. And like this world where health data is more like financial data also means you’re empowered. You’re in control. You’re the owner. It’s actually a strong parallel because we all are optimizing for financial security and retirement, but how do you know you’re going to be there to enjoy it. And in this world, this is how like you have that projection that tells you your trajectory into the future. And if you stay on course, you can feel very, very confident in a data-driven way that this is going to work out for you.”

https://s3-us-west-2.amazonaws.com/secure.notion-static.com/90639d6a-4531-4d8d-8e41-54ca535bb405/Your_health_401(k)_-_Build_the_Future.mp4

31:32- Reaching for the literal stars

The long-term payoff of globally better health? The confidence and security to get the human race interstellar.

“I’m a big space nerd. I think a lot about actually when I was at SpaceX, I worked on the life support system and  I think about the future. And if we ever want to go deep into space or colonize another planet, we have to have a really strong handle on wellness, on health,  and physiology. Like you can’t have high rates of diabetes and cancer following you to a base out on the stars. And so that’s what I really get excited about is if we can crack the code of metabolic health and longevity, it opens up opportunity for the human species in a really serious way where we’re no longer limited by healthcare systems and hoping for the best of insurance plans. We can confidently move into a future where you’re making choices as a spacefaring civilization with generational thoughts. And I don’t know that that might sound a little bit fan fiction to you, but I truly believe that is the key criteria to be able to move ahead into the next big step for mankind.”

1:24 – Data goes health-conscious

With data analytics tech at our fingertips, applying it to optimize our health is the logical next step.

“So the vision is to reverse the trends of metabolic dysfunction in the developing world by giving people access to their own health information at the moment that it matters. Every day we all sit down, we’re going to eat lunch. We’re going to make a choice. Why do we make that choice? Right? What are the reasons that we’re choosing to eat that lunch that we choose and why? A lot of the time we’re basing these things on emotion, on the advice of others on internet searches. In this world where we have a microelectronics revolution that is allowing this miniaturization of technology that otherwise would never have been able to leave the lab – we need to be leveraging this in society. And, you know, we use data throughout our lives with the exception of health and wellness. And so Levels is there to be providing easy, actionable insights to help you make better choices and ultimately allow human flourishing by giving people access to their own information at the moment that is valuable.”

2:19 – Lower glucose, save the world

In a world plagued by metabolic dysfunction, a growing health and diet awareness can prevent the leading causes of early death.

***“*So Levels is focused – or the metabolic fitness companies are focused – on the space of metabolic health. And the reason we’ve chosen this is because it is the unspoken epidemic that is causing the most destruction across the world. In every developing country, specifically the United States, metabolic dysfunction is the leading cause of death. If it’s not specifically a metabolic failure that leads to morbidity, it’s a closely associated comorbidity. And so we’re talking about things like PCOS, pre-diabetes, type two diabetes, cardiovascular disease, stroke, Alzheimer’s. All of these are metabolic in nature, very closely related to metabolic dysregulation…And so metabolic dysfunction is when these processes start to break down and we have harmful byproducts, hormones, and control of the glucose-insulin feedback loop break down. And we start to damage tissue. We start to age prematurely, free radicals inflammation, all of that starts to build. And ultimately, that is what leads to end of life. And so it’s an accelerating aging process, basically. So we’ve chosen the metabolism, because again, seven of the top 10 reasons people are losing their lives early are related to metabolic dysfunction. And it doesn’t have to be this way.”

6:15 – Empowerment through data

How can we make a difference to our health? By capturing the real-time, data-driven results of our diet and actions.

“When you sit down to eat lunch right now, it seems like you need a Ph.D. to figure out what you should put on your plate. And so when you’re operating in that world, you can’t blame people who are busy and trying to live their lives for ultimately having to just make a choice that they enjoy. So we’re doing things based on emotion. We’re guided by flavors, for example, or we’re guided by – if we are taking data – it’s the bathroom scale. So we’re like, ‘Oh man, I’ve gained a few pounds. I should stop eating.’ We can’t blame specific foods and we can’t understand how specific choices are affecting us because the feedback loop is so open and ultimately broken. And so by connecting a person with the reactions their body experiences from a specific action in real time, giving them data that associates the metabolic outcome of a certain choice – we can close that loop. We now can connect the action to the reaction, put that information in the hands of the individual and they can now understand specifically why they should choose one behavior over another. And so that’s the real power.”

9:52 – Warning: choices may be less healthy than they appear

Josh’s personal experience taught him that so-called healthy diets can still be hurting your personal metabolic response.

“I personally started this whole process that ultimately led to Levels because even though I’m a CrossFit level two trainer and I was working out daily, I was experiencing extreme fatigue levels throughout the day, like total fluctuations. I’d feel an energy boost and then 20 minutes later, an hour later I’d be crashing and I’d be like crawling back to the coffee machine. That experience was caused ultimately, I found, by the hormonal imbalance, the insulin waves that I was experiencing as a result of my dietary choices. And at the time I was not eating, you know, what would be traditionally thought of as an unhealthy diet. The staples of my diet were brown rice and sweet potatoes, but the quantities I was eating them in and my own personal sensitivity to them was causing this huge blood sugar excursion into the pre-diabetic range, which would lead to this overcompensation of insulin. And people are experiencing this daily and they’re experiencing it in response to choices they think are objectively healthy.”

11:49 – Getting to know your body

Toss out the Atkin’s diet – studies show that each individual processes sugars and food types differently, and understanding your body leads to healthier choices.

“We call it food freedom. But it’s the concept of the realization that you are an individual. You’re not an average. And what we do in modern diet theory and nutrition is we average out everyone and we turned it into an optimal diet. We say, this is the diet for everyone. Everyone should eat this way. What we’re doing is we’re erasing the individual reality. And so CGM technology, continuous glucose monitoring technology specifically, has recently uncovered this reality of metabolic personalization. So you may have heard of this trial that came out in 2015, in which 800 non-diabetic people were given continuous glucose monitors. And during the trial, they ate all these standardized meals. And, at the end, they went back and looked at the data and had this amazing realization that two people can have the exact same two foods and have equal and opposite blood sugar responses to them. So we’re talking about no response, for example, to a cookie and a huge blood sugar response to a banana and then for a different person, the exact opposite. So how can you know if you’re that banana or cookie person unless you have that data.”

15:15 – From reactive to proactive choices

Levels currently can only evaluate your past choices, but Josh sees a path towards active recommendations and diet scheduling for your lifestyle.

“All of these molecules that really do matter, they’re quarantined in the world of boutique medicine. If you get this extremely expensive lab work, you can have an idea of where you stand on all these metrics. We’re going to see a transition to very real-time, continuous monitoring, where you have a bio wearable on your body somewhere that is analyzing these analytes in real-time and delivering you low-hanging fruit, no pun intended, for better behavior. So right now we’re reactive. We’re saying, monitor and then find the problems and change them. In the future, we’ll be proactive. It’ll be, ‘Hey, you know, it’s Tuesday morning, you’ve got a training event on your calendar. Here’s the recommended fuel source before you go out and get on the biker or go for that swim’. Or you’re trying to lose weight, you could potentially do so by simply staying in a low-glycemic state and optimize cholesterol simultaneously by having real-time monitoring of both. And you don’t have to restrict calories, you just eat differently. Right? These are the things that unlock when you start to have real-time data at the individual level.”

16:44 – Dreaming bigger, Levels-style

Levels isn’t just another start-up, it’s the stepping stones towards a happier, healthier, and richer future for humankind.

“I can envision a future where we’re like striding into our nineties fitter and wiser than ever. And without that unnecessary breakdown. Now, I’m not someone who believes that we’re going to achieve immortality. Of course, I don’t know. I don’t know enough about it, but I do think that we have a ton of unnecessary aging and breakdown that is a by-product of our lifestyles. Nobody, again, wants to be in that situation. It’s just we don’t have any feedback as we’re going through life. And so I think that the beautiful consequence of having that real-time information guiding us throughout life is that we’ll have so much more richness and value at both ends of the spectrum. When we’re younger, we’ll be able to make better choices and experience better – our quality of life will be better. And as we’re older, we’ll be able to age more gracefully and be in more control. And I don’t want to make it all about productivity, but it just unlocks so much for society.”

18:15 – Think beyond the antibiotic

We tend to treat the symptoms of metabolic dysfunction with medication – but data-driven choices can be far more effective.

“I also think that the mechanisms are so misunderstood. We think that we have to treat everything with pills and with procedures or something like that. Part of it is with our society in general, we like to have a problem that we can solve. And so if we can put pills or a procedure on it, it’s like we can check that box and then we fix the problem. But the reality is that this is a much more nuanced world. The world of human physiology and health is super coupled. Again, we’re this chemistry set. And if things are out of whack, we just like throw more chemicals at the problem and assume that’s going to correct it. And what we’re doing is we’re just covering up the symptom. And so what I think is, is really extraordinary about being able to use a data-driven approach is that we can target and improve these sort of chemical disturbances.”

20:20 – Putting you in the driver’s seat

In a world of generic diet advice, real-time personalized data gives users strong control over their choices and health impacts.

“I think that most people really do respond positively to this opportunity. They understand that they are different than other people, and they’ve maybe tried a diet that was recommended to them by a friend or something. And it didn’t feel right. So we have this sort of intraception where we think that something’s off, or we can perceive that there’s no one size fits all. But then when you actually have information from your own body, telling you how to make better choices or what is working against you? It’s very hard to ignore, it’s not something most people are used to. We don’t have closed feedback loops from our bodies. It’s an eye-opening experience once you, for the first time, hear your body speak back to you and you can make choices in a closed-loop, it’s a really empowering situation to be in. And that’s why I’m so optimistic for it – it doesn’t feel the same as the sort of age-old advice of ‘eat healthier and work out more.’ It’s seeing that when you eat healthier, your body is healthier. And when you work out more, you have better control or you can maybe even indulge a little bit more without seeing dysfunction. And so all these little micro-optimizations that you can see and really verify for yourself, it’s like putting you in the driver’s seat instead of always feeling like you’re on the backseat.”

21:54 – Use it your way

Levels – and CGM in general – can be used for any performance or health improvement goals that you have for your lifestyle.

“We all have different performance goals, you know, and it could be just being a good performer at work. It might be being a better spouse, better husband, father, mother, sibling, there’s all these different reasons that we need to be good performance and be kind of on top of our game to enjoy life. And then you’ve got the metabolic health spectrum, which is like, maybe you want to lose weight. Maybe you want to shave seconds off your 50K time or something. There’s like all of these different reasons that you would care about metabolic optimization, but when it comes down to at the very, very basic level is it’s the same few molecules that drive our energy balance. And so if we’re empowered, no matter where we land on the metabolic health spectrum or what our goals are for, to access and make choices that either improve the molecules that are at play. Ultimately we basically closed the loop between better choices over a short time period, leading us closer to our goals.”

27:04 – Your health 401(k)

As biotech capability grows, Josh envisions a  future where you can track, invest in, and project multiple factors of your health just like your retirement fund.

“I would say project forward, you have kind of a smart health stack where you’re taking data on those big four levers, sleep, stress, diet, and exercise. Those are the things that you can control at the individual level. And you are currently making choices every day on all four of those. It’s just whether or not you’re paying attention. So once you have data on all four, that’s where we sort of step into the world where metabolic health data is more like financial data. So you’ve got like a real-time portfolio of data streams. You’re making choices in a closed loop. You have the deposits and withdrawals, right. You’ve got a projection into the future. You’ve got expert guidance if you need it, that you can opt into. This is all available in the moment while you’re riding the subway or whatever, you pull your phone out, take a look at how you’re doing and adjust your expectations or adjust your choices that day to optimize. And like this world where health data is more like financial data also means you’re empowered. You’re in control. You’re the owner. It’s actually a strong parallel because we all are optimizing for financial security and retirement, but how do you know you’re going to be there to enjoy it. And in this world, this is how like you have that projection that tells you your trajectory into the future. And if you stay on course, you can feel very, very confident in a data-driven way that this is going to work out for you.”

31:32- Reaching for the literal stars

The long-term payoff of globally better health? The confidence and security to get the human race interstellar.

“I’m a big space nerd. I think a lot about actually when I was at SpaceX, I worked on the life support system and  I think about the future. And if we ever want to go deep into space or colonize another planet, we have to have a really strong handle on wellness, on health,  and physiology. Like you can’t have high rates of diabetes and cancer following you to a base out on the stars. And so that’s what I really get excited about is if we can crack the code of metabolic health and longevity, it opens up opportunity for the human species in a really serious way where we’re no longer limited by healthcare systems and hoping for the best of insurance plans. We can confidently move into a future where you’re making choices as a spacefaring civilization with generational thoughts. And I don’t know that that might sound a little bit fan fiction to you, but I truly believe that is the key criteria to be able to move ahead into the next big step for mankind.”